Provider Demographics
NPI:1396472445
Name:STONEBRAKER, JULIA ROSE (PHARMD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:STONEBRAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17436 FLEMING ST APT 203
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-8338
Mailing Address - Country:US
Mailing Address - Phone:812-929-0074
Mailing Address - Fax:
Practice Address - Street 1:1505 E 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-2392
Practice Address - Country:US
Practice Address - Phone:317-254-9206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029833A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist